Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | MD13702 | OR |
NPI | 1164533667 |
---|---|
Provider Name | Stephen B Kornfeld |
First Address | Bend, OR 97708-5579 |
Second Address | Bend, OR 97701-6015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 06/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00411269 | RAILROAD MEDICARE (01) | OR |
026976 | (05) | OR |
E02862 | (02) | OR |